Does the mixing method of AH Plus Jet affect its physicochemical and mechanical properties?

INTRODUCTION: The purpose of this study was to evaluate whether the mixing method of AH Plus Jet sealer affects its physicochemical and mechanical properties. METHODS: The properties of AH Plus Jet sealer were analyzed when mixed using either the Auto Mix Tip or manual mixing. The evaluated properties included radiopacity (n=5), initial and final setting times (n=5), flow (n=5), and solubility (n=3), following specifications outlined in ISO 6876/2012 and ADA Nº 57/2000. pH levels were measured at intervals of 3, 24, 72, and 168 hours (n=10). The push-out bond strength test was conducted using a universal testing machine and using bovine teeth (n=30). Failure modes were analyzed with stereomicroscopy. Porosity was evaluated under micro-CT (n=5) and scanning electron microscopy was also performed (n=5). One-way analysis of variance and Tukey, unpaired t-tests, or Mann-Whitney tests were used with a significance level of 5%. RESULTS: The Auto Mix exhibited a radiopacity value of 12.11 mmAl, whereas manual mixing resulted in 12.55 mmAl (P>0.05). For initial and final setting times, Auto Mix showed 901 minutes and 1779 minutes, respectively, while manual mixing recorded values of 631 minutes and 1504 minutes (P<0.05). In terms of flow, Auto Mix demonstrated higher values (25.26 mm) than manual mixing (21.71 mm) (P<0.05). No statistical differences were observed between the two methods for solubility and pH (P>0.05). Manual mixing presented a higher bond strength value (14.52 MPa) than Auto Mix (9.81 MPa) (P<0.05). The mixed failure mode was the most frequent outcome for both methods. The highest porosity was observed for Auto Mix (P<0.05). Scanning electron microscopy analysis revealed that manual mixing resulted in a smoother surface with fewer pores and smaller, more evenly distributed agglomerates compared to automatic mixing. CONCLUSION: The mixing method employed for AH Plus Jet sealer influences some physicochemical and mechanical properties of the material.

Impact of different agitation methods on smear layer cleaning of mesial canals with accentuated curvature.

Objectives: This study evaluated the impact of different methods of irrigant agitation on smear layer removal in the apical third of curved mesial canals of 3 dimensionally (D) printed mandibular molars. Materials and Methods: Sixty 3D-printed mandibular second molars were used, presenting a 70° curvature and a Vertucci type II configuration in the mesial root. A round cavity was cut 2 mm from the apex using a trephine of 2 mm in diameter, 60 bovine dentin disks were made, and a smear layer was formed. The dentin disks had the adaptation checked in the apical third of the teeth with wax. The dentin disks were evaluated in environmental scanning electron microscope before and after the following irrigant agitation methods: G1(PIK Ultrasonic Tip), G2 (Passive Ultrasonic Irrigation with Irrisonic- PUI), G3 (Easy Clean), G4 (HBW Ultrasonic Tip), G5 (Ultramint X Ultrasonic tip), and G6 (conventional irrigation-CI) (n = 10). All groups were irrigated with 2.5% sodium hypochlorite and 17% ethylenediaminetetraacetic acid. Results: All dentin disks were 100% covered by the smear layer before treatment, and all groups significantly reduced the percentage of the smear layer after treatment. After the irrigation protocols, the Ultra-X group showed the lowest coverage percentage, statistically differing from the conventional, PIK, and HBW groups (p < 0.05). There was no significant difference among Ultramint X, PUI-Irrisonic, and Easy Clean (p > 0.05). None of the agitation methods could remove the smear layer altogether. Conclusions: Ultramint X resulted in the most significant number of completely clean specimens.

Referred pain is associated with greater odontogenic spontaneous pain and a heightened pain sensitivity in patients with symptomatic irreversible pulpitis.

BACKGROUND: Symptomatic irreversible pulpitis often results in heightened reactions to thermal stimuli such as pain evoked by a cold stimulus, and spontaneous odontogenic pain (unprovoked pain). OBJECTIVE: This study primarily compared the clinical manifestations of odontogenic spontaneous pain and pain provoked by cold stimulus specifically focusing on their sensory discriminative characteristics (intensity, duration and quality) between symptomatic irreversible pulpitis patients with and without referred pain. METHODS: Twenty-three patients with symptomatic irreversible pulpitis with referred pain and 12 patients without referred pain were included in this cross-sectional study. The following outcomes were assessed: odontogenic spontaneous pain and its descriptors; pain evoked by cold stimulus and qualitative sensory testing before and after local anaesthesia; referred pain location; use of analgesic medication; complementary anaesthesia efficacy. T-test, chi-squared and McNemar tests were applied to the data (p < .50). RESULTS: Patients with referred pain presented a greater odontogenic pain intensity (p < .05) when considered the average of the last 24 h. These patients also showed higher pain rating and pain descriptors (p < .05). Intensity and duration of the pain evoked by cold stimulus in the non-affected contralateral tooth at baseline were higher for patients with referred pain (p < .05). CONCLUSION: Symptomatic irreversible pulpitis patients with referred pain present greater odontogenic spontaneous pain and a heightened pain sensitivity. Therefore, patients with referred pain seem more complex from a pain severity perspective, supporting the clinical utility of discriminating symptomatic irreversible pulpitis with and without referred pain.

Biaxial flexural strength of hydrothermally aged resin-based materials.

PURPOSE: The strength of temporary restorations plays a vital role in full-mouth reconstruction, and it can be impacted by the aging process. The aim of this in vitro study was to evaluate the biaxial flexural strength and fractographic features of different resin-based materials submitted to thermal aging. MATERIAL AND METHODS: One hundred and ninety-two resin disc-shaped specimens (6.5 mm in diameter and 0.5 mm in thickness) were fabricated and divided into six experimental groups according to the resin-based materials (Filtek Bulk-Fill flowable resin; J-Temp temporary resin; and Fuji Lining glass ionomer cement) and aging process (before and after thermal cycling). Biaxial flexural strength test was performed using a universal testing machine at a crosshead speed of 0.5 mm/min before and after thermal cycling (5 °C and 55 °C, 5760 cycles, 30 s). The mechanical properties were assessed using Weibull parameters (characteristic strength and Weibull modulus) (n = 30). Fractured specimens were examined under a polarized light stereomicroscope to identify crack origin and propagation direction. The surface microstructure of the resin-based materials was assessed by scanning electron microscopy (n = 2). The Weibull modulus (m), characteristic strength, and reliability properties were calculated, and a contour plot was used to detect differences among groups (95% confidence interval). RESULTS: The Weibull modulus (m), characteristic strength, and reliability of the resin-based compounds were influenced by material type and thermal aging (p < 0.05). Weibull modulus (m) revealed no differences when comparing the materials and aging process (p > 0.05), except for the preceding aging period where Filtek Bulk-Fill exhibited higher values compared to J-Temp (p < 0.05). Filtek Bulk-Fill demonstrated superior characteristic strength and reliability compared to J-Temp and Fuji Lining before and after thermal cycling (p < 0.05). Fractography of the resin-based materials showed fractures originating from surface defects exposed to tensile side and their propagation toward the compressive side. Generally, no differences in surface microstructure were observed on micrographs before and after thermal aging for Filtek Bulk-Fill and Fuji Lining. However, the aging process developed flaws in J-Temp. CONCLUSION: Resin-based material composition resulted in different flexural strength performance, impacting the Weibull modulus (m), characteristic strength, and reliability of the resin-based restorations.

Publication trends of the Journal of Esthetic and Restorative Dentistry: A bibliometric analysis.

OBJECTIVE: The Journal of Esthetic and Restorative Dentistry (JERD) stands out as one of the most prominent international journals publishing research in esthetic dentistry. This study analyzed articles published by JERD since the year 2000 through bibliometric analysis. METHODOLOGY: The search was conducted in January 2024 using Scopus. The following data were extracted from the articles: citation count, year, language, access type, funding agency, study design, theme (general and specific), country, institution, authors, and keywords. The VOSviewer software was used to generate collaborative network maps among the data. Dimensions were consulted to measure altmetric data. Google Trends was used to investigate the global popularity of JERD research. RESULTS: A total of 1394 articles were included in this analysis. Citation count ranged from 0 to 625 (average: 16.9). Articles were published between 2000 and 2023. Laboratory studies were more prevalent (n = 850), with the most investigated general theme being restorative procedures (n = 882), and the highlighted specific theme being the use of composite resin (n = 327). The United States had the highest number of articles (n = 640), with the diverse distribution among other countries. The most common keyword was "cad/cam" (n = 63). VOSviewer demonstrated high collaboration among countries. Intense mentions were identified primarily on Facebook. According to Google Trends, Egypt was the country that searched for JERD the most. CONCLUSIONS: JERD exhibited significant growth in the number of published articles and their diversity by topics, types, origin (country), number of citations, and impact factor. CLINICAL SIGNIFICANCE: The JERD is a journal that publishes studies influencing clinical practice. Identifying the key characteristics of this journal is essential for charting future paths.

Biological response to endodontic treatment in one versus two-visit: a systematic review and meta-analysis of animal studies.

OBJECTIVES: To perform a systematic review of animal studies that compared the histopathological characteristics between teeth with apical periodontitis after endodontic treatment in one or two visits. MATERIALS AND METHODS: This systematic review was registered on the International Prospective Register of Systematic Reviews (PROSPERO) - CRD42022340849. Studies were collected from PubMed/MEDLINE, LILACS, EMBASE, Livivo, SciELO, Web of Science, Scopus, and Cochrane Library and manual and gray literature searches. Animal studies that evaluated histological characteristics after endodontic treatment of teeth with apical periodontitis in one or two visits were included. Risk of bias analysis of the included studies was performed using the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) tool. Data synthesis of the included studies with quantitative data was performed, and meta-analysis was conducted with the Comprehensive Meta-Analysis software, using the random effects model and odds ratio (OR). RESULTS: Eighteen studies met the inclusion criteria (Kappa = 0.891). Meta-analyses indicated values in inflammatory infiltrate intensity with effect size of 5.5% (95% CI: 0.020-0.148; p < 0.001), periodontal ligament thickness: 25.6% (95% CI: 0.134-0.487; p < 0.001), dentin resorption: 13% (95% CI: 0.015-1.141; p = 0.066), cementum resorption: 7.1% (95% CI: 0.015-0.325; p = 0.001), bone resorption: 1.4% (95% CI: 0.002-0.130; p < 0.001), mineralized tissue resorption: 42.8% (95% CI: 0.110-1.671; p = 0.222), biological apical sealing: 13.1% (95% CI: 0.055-0.314; p < 0.001), and presence of microorganisms: 10.3% (95% CI: 0.014-0.747; p = 0.025). CONCLUSIONS: When considering animal studies, the two-visit endodontic treatment, using calcium hydroxide-based intracanal medication, resulted in better biological repair characteristics. CLINICAL RELEVANCE: A two-visit endodontic treatment with calcium hydroxide-based intracanal medication yields superior histopathological outcomes.

Micro-CT Assessment of Filling Removal Effectiveness in the Apical Third of Curved Canals with Different Types of Anatomy.

Introduction: The aim of this study was to assess the effectiveness of filling removal material from the apical third of curved mesial root canals of mandibular molars. Reciprocating instrumentation followed by additional rotary instrumentation with instruments made of alloys with different heat treatments was evaluated. Materials and Methods: Thirty-six mesial roots of mandibular molars were divided into two groups: Group Class IV consisted of 16 roots with two independent canals, and Group Class II consisted of 20 roots with two canals that merged into one at their apical level. Each of these two groups were further divided into two subgroups, according to the additional rotary instrument used after the reciprocating instrumentation: Group RH and Group RM for Hyflex and Mtwo, respectively. After each procedural step, the roots were scanned by micro-tomography. After each step of filling removal, the Wilcoxon matched pair test and the Mann-Whitney test were used for the evaluation between groups. The significance level adopted was 5%. Results: Significant differences were observed between groups with different Class II and Class IV anatomies, regarding filling removal after Reciproc (P<0.05). After the use of an additional rotary instrumentation, no differences were observed between the two groups (P>0.05). Conclusions: In the apical third of mesial roots of mandibular molars with Class II anatomy, an additional rotary instrumentation was shown to be necessary for improving the removal of filling material after using the single-file reciprocating instrumentation technique.

A Global Overview of Guided Endodontics: A Bibliometric Analysis.

INTRODUCTION: This review aimed to analyze the trend and main characteristics of articles related to guided endodontics (GE). METHODS: The search was conducted in May 2023 on Web of Science. GE-related articles were included, and conferences were excluded. Three researchers selected the articles and extracted: the number of citations; year and journal; design and study theme; authorship and institutions; country and continent. Collaborative networks were generated in the Visualization of Similarities Viewer software. The relationship between data was determined by Spearman's correlation. Google Trends was used to investigate the global popularity of GE research. RESULTS: The search resulted in 135 articles, of which 85 were included. The most cited article totaled 116 citations. The studies were published between 2016 and 2023, most frequently in 2022 (n = 22). The most prevalent journal was the Journal of Endodontics (n = 28). Case report (n = 38) was the most frequent study design. The most studied theme was the use of static GE for calcified canals (n = 27). Connert T was the author with the highest number of articles (n = 13). The University of Basel (n = 9) stood out. The most prevalent country was Brazil (n = 13). Europe was the most frequent continent (n = 38). Visualization of Similarities Viewer demonstrated an interaction between authors. There was a moderate positive correlation between citations and the impact factor (rho = .483). According to Google Trends, the United States was the country that most researched GE. CONCLUSIONS: Based on this review, a more significant research interest in GE was observed in Europe, addressing the application of GE in locating severely calcified root canals.

Endodontic treatment as a Reduction in the Risk of infective Endocarditis in a Male Patient with Eisenmenger Syndrome

This case report aimed to describe the importance of endodontic treatment in reducing infectious foci in patients with Eisenmenger syndrome (ES) and describe the characteristics of ES, so that the endodontist can safely treat these patients. A 57-year-old male with ES sought dental care complaining of dental pain. Irreversible pulpitis was diagnosed in tooth 37 and pulp necrosis in teeth 36, 34 and 31. Tests of prothrombin time (PT), activated partial thromboblastin time (APTT) and international normalized ratio (INR) were prescribed to evaluate the profile of coagulation using Marevan and antibiotic prophylaxis with amoxicillin. The endodontic treatments were performed. At the end, the patient reported no pain or discomfort in the teeth and improved masticatory function. The removal of oral infectious foci in patients with ES is important to reduce the risk of IE, which could seriously compromise the health and overall prognosis of the patient.

Este reporte de caso tuvo como objetivo describir la importancia del tratamiento endodóntico en la reducción de focos infecciosos en pacientes con síndrome de Eisenmenger (SE) y describir las características del SE, para que el endodoncista pueda tratar con seguridad a estos pacientes. Un hombre de 57 años con ES buscó atención dental quejándose de dolor dental. Se diagnosticó pulpitis irreversible en el diente 37 y necrosis pulpar en los dientes 36, 34 y 31. Se solicitaron pruebas de tiempo de protrombina (PT), tiempo de tromboblastina parcial activada (TTPA) y índice internacional normalizado (INR) para evaluar el perfil de coagulación utilizando Marevan y profilaxis antibiótica con amoxicilina. Se realizaron los tratamientos de endodoncia. Al final, el paciente no refirió dolor ni molestias en los dientes y mejoró la función masticatoria. La eliminación de focos infecciosos orales en pacientes con ES es importante para reducir el riesgo de EI, que podría comprometer gravemente la salud y el pronóstico general del paciente.

Effectiveness of a new endodontic irrigation system for removing smear layer and dissolving simulated organic matter.

OBJECTIVES: The study aimed to evaluate the potential for the dissolution of organic tissue in areas of simulated complexity and cleaning of root canal walls of the new iVac® endodontic irrigation system. MATERIAL AND METHODS: Thirty mandibular premolars were evaluated by scanning electron microscopy before and after biomechanical preparation. Then, they were distributed according to the final irrigation protocol into groups with conventional irrigation, ultrasonic agitation with metallic insert (UA), and iVac® system, and new photomicrographs were obtained. For tissue dissolution analysis, glass capillaries filled with catgut were attached to the cervical and apical thirds of twenty-one prototyped upper incisors. They were weighed before and after the previously mentioned irrigation protocols. The data were statistically compared with a significance level of 5%. RESULTS: The final irrigation provided greater cleaning of the root canal walls in the cervical, middle, and apical thirds of the root canals (P < 0.05), with no statistically significant difference between UA and iVac®, regardless of the analyzed thirds. Both ultrasonic irrigation protocols dissolved a significantly greater volume than the conventional irrigation protocol (P < 0.05), with no difference between the two protocols (P < 0.05). CONCLUSIONS: The iVac® system showed root canal wall cleaning and tissue dissolution similar to UA with a metallic insert, and both were superior to conventional irrigation. CLINICAL RELEVANCE: The new irrigation system iVac is more effective than conventional irrigation and has similar root canal wall cleaning and tissue dissolution to UA.

Divergence between confidence and knowledge of endodontists regarding non-odontogenic pain.

INTRODUCTION: This study aimed to assess the self-reported levels of confidence and knowledge related to non-odontogenic pain among a group of Brazilian endodontists. METHODOLOGY: A total of one hundred and forty-six endodontists affiliated with the Brazilian Society of Endodontics participated in the survey. The questionnaire, distributed via email or WhatsApp, contained inquiries designed to gauge self-perceived confidence and knowledge concerning non-odontogenic pain. The practitioners were categorized into four groups based on their self-reported familiarity with various orofacial pain types, classified as either sufficient or insufficient, and on their engagement in ongoing educational programs related to orofacial pain. Data were analyzed by Chi-Square Test and Fischer's exact test (p<0.05). RESULTS: Overall, self-reported confidence about non-odontogenic pain was high, especially for endodontists who considered their knowledge about orofacial pain sufficient, regardless of whether they had (71.1% - 97.8%) or not (35.7% - 96.4%) been continuously involved in education courses on orofacial pain. In general, self-reported knowledge about non-odontogenic pain was insufficient (0% - 42%), except in the question about how they would act in cases of pain that persists beyond the normal healing time after an endodontic procedure (70.6% - 81.9%). In general, endodontists are confident in their diagnosis and treatment of non-odontogenic pain. Nonetheless, this confidence did not correlate with a commensurate knowledge depth of. Thus, specialization courses in endodontics should highly consider training and qualifying these professionals in the diagnosis of non-odontogenic pain.

CYCLIC AND TORSIONAL FATIGUE RESISTANCE OF THERMALLY TREATED ROTARY NiTiINSTRUMENTS WITH DIFFERENT DESIGNS

Aims: The aim was to evaluate the cyclic and torsional fatigue resistance among thermally treated NiTi rotary instruments with different design features.Materials and methods: Sixty instruments of three systems were used (n=20): TruNatomy 26.04 (TN 26.04), BassiLogic 25.05 (BL 25.05), and Flat File 25.04 (FF 25.04). The cyclic fatigue test (n=10) was performed to evaluate the time to fracture (s) and the number of cycles until failure (NCF). The torsion test was performed to evaluate the torque (N.cm) and maximum angular deflection until fracture (n=10). The fracture surface of each fragment was examined under a scanning electron microscope. The data were analyzed by Tukey's test (p<0.05).Results: BL 25.05 and FF 25.04 instruments had a higher number of cycles and time to fracture compared with TN 26.04 (p<0.05). TN 26.04 instruments showed lower torque to fracture.Conclusions: Based on the proposed objectives and the methodology used, TruNatomy 26.04 instruments present lower resistance to cyclic fatigue and torsional fatigue when compared to BassiLogic 25.05 and Flat File 25.04 instruments.

Cyclic and torsional fatigue resistance of a new rotary file on a rotary and reciprocating motion.

This study evaluated the cyclic and torsional fatigue resistance of a new nickel-titanium (Flat File 25.04) instrument on the continuous and reciprocating motion. Sixty instruments of the ProDesign Logic2 25.03 and 25.05 (Easy Equipamentos Odontológicos, Belo Horizonte, Brazil), and MK Flat File 25.04 (n = 20) (MK Life, Porto Alegre, Brazil) were used. For the cyclic fatigue test, an artificial stainless steel simulated canal with an angle of 60° and a radius of curvature of 5 mm located 5 mm from its tip was used. The torque and rotation angle at the instruments' failure on the torsional fatigue test was based on the ISO 3630-1 protocol, in which the 3 mm tip of each instrument was fixed and connected to an electric motor and a load cell. The fractured surface of each fragment was examined by scanning electron microscopy. Data were analyzed using a 1-way analysis of variance and Tukey's test with a significance level of 5%. Flat File 25.04 had lower cyclic fatigue in both kinematics than the Logic instruments (p < .05). Reciprocating motion improved the cyclic fatigue of the tested instruments (p < .05). Flat File 25.04 had similar torque to Logic2 25.05 (p > .05), and both were superior to Logic2 25.03 (p < .05). The angular deflection values were different for the three tested instruments (p < .05), in the decreasing order: Logic2 25.03, 25.05, and Flat File 25.04. Flat File presented good resistance to cyclic and torsional fatigue resistance. Reciprocating motion improved the cyclic fatigue resistance of the instruments and can be considered when using programmable motors. RESEARCH HIGHLIGHTS: Scanning electron microscopy evaluation of different endodontic rotary file and fatigue resistance tests.

The use of sodium hypochlorite mixed with etidronic acid during canal preparation increases debris extrusion.

The purpose of this study was to compare the impact of different irrigation protocols on debris extrusion. Single-rooted teeth were distributed into groups based on the irrigation protocols (n = 40): 2.5% NaOCl (biomechanical preparation: 20 mL and final irrigation: 5 mL); 2.5% NaOCl (biomechanical preparation: 20 mL) + 17% EDTA (final irrigation: 2 mL) + 2.5% NaOCl (final irrigation: 3 mL); and a mixture of 5% NaOCl +18% HEDP (biomechanical preparation: 20 mL and final irrigation: 5 mL). The canals were prepared using a reciprocating instrument size 40/0.06. For final irrigation, the groups were reassigned based on the agitation methods (n = 10): (a) no agitation; (b) ultrasonic; (c) sonic; and (d) continuous rotation. The control group (n = 10) received saline solution without agitation. The amount of debris extruded was measured by weight and analysed using One-way ANOVA (α < 0.05). The subgroups treated with NaOCl + HEDP mixture showed a significantly higher amount of extruded debris (p < 0.05), while there was no difference among agitation methods in all groups (p > 0.05).

Evaluation of cyclic and torsional fatigue resistance of several heat-treated reciprocating nickel-titanium instruments.

This study investigated the cyclic fatigue and torsional resistance of Unicone Plus (UCP 25.06), Unicone (UC 25.06), Reciproc Blue (RB 25.08) and Wave One Gold (WOG 25.07) performed at body temperature (35° ± 1°C). Time and number of cycles to fracture (NCF), as well as torque and angular deflection were recorded. Fractured surfaces were evaluated by scanning electron microscopy (SEM). Data were analysed using one-way ANOVA and Holm-Sidak's tests for multiple comparison. The RB had a significantly higher time to fracture, followed by the WOG and UCP (p < 0.05). Regarding the NCF, there was no significantly difference between RB and WOG (p > 0.05). UC presented highest torque values and the lowest angular deflection (p < 0.05). SEM analysis demonstrated typical failures features in both cyclic and torsional fatigue tests. Overall, UC had the lowest time, NCF and angular deflection at fracture. RB presented the highest time to fracture and angular deflection values.

Ex Vivo Evaluation of the Efficacy of Photodynamic Therapy in Eliminating Enterococcus faecalis from Dentinal Tubules by Confocal Laser Scanning Microscopy.

INTRODUCTION: The aim of the present study was to investigate ex vivo by confocal laser scanning microscopy the antibacterial effect of photodynamic therapy (PDT) on dentinal tubules in the apical 5 mm of human mandibular premolars contaminated with Enterococcus faecalis. METHODS: Thirty-four teeth were standardized to 20 mm and foraminal anatomic diameters using a #20 K-file (Dentsply Maillefer). Samples were contaminated for 21 days and divided into the following 3 experimental groups (n = 10): the PDT group (instrumented canals and PDT), the passive ultrasonic irrigation (PUI) group (instrumented canals and PUI), and the PUI-PDT group (instrumented canals, PUI, and PDT), along with a control group (n = 4) (noninstrumented canals). The canals in the experimental groups were instrumented with ProTaper Next (Dentsply Maillefer) up to X3 and rinsed with EDTA and sodium hypochlorite. The photosensitizer used was 0.01% methylene blue with a preirradiation time of 5 minutes and a diode laser with 4 J energy and a 660-nm wavelength. Cross sections were made 5 mm from the apex of all samples, which were analyzed using confocal laser scanning microscopy. The results were analyzed using the Shapiro-Wilk and Kruskal-Wallis (Dunn) tests. RESULTS: There was a lower percentage of live bacteria in the PUI-PDT group, with a statistical difference compared with the control and PDT groups (P < .05). There was no statistical difference in the percentage of live bacteria between PUI-PDT and PUI (P > .05). CONCLUSIONS: It was concluded that the PUI-PDT association was most effective in disinfecting root canals compared with the control group and PDT.

Postoperative Pain After Using Passive Ultrasonic Irrigation and EasyClean Device, Irrigation Activation Techniques: A Randomized Clinical Trial.

INTRODUCTION: This randomized clinical trial aimed to compare postoperative pain after the use of 2different irrigation activation techniques: passive ultrasonic irrigation and the EasyClean device. METHODS: Sixty-six single-rooted teeth diagnosed with asymptomatic pulp necrosis and apical periodontitis were randomly assigned to 2experimental groups (n = 33), which differed in the irrigation activation technique. Postoperative pain levels were assessed after 24, 48, and 72 hours using a verbal rating scale; the ibuprofen intake amount was recorded at the same time intervals. Data were analyzed using Student's t-test, Mann-Whitney U and Fisher's exact tests, with a significance level of 5%. RESULTS: Postoperative pain levels and analgesic intake frequency were not significantly different across the 2irrigation activation techniques (P > .05). The frequencies obtained in relation to the prevalence of postoperative pain were 3.1-25.8% for all participants of the 2studied groups. CONCLUSION: The irrigation activation techniques of passive ultrasonic irrigation and the EasyClean device were found to be equivalent in terms of postoperative pain and analgesic intake.

Comparative analysis of torsional and cyclic fatigue resistance of ProGlider, WaveOne Gold Glider, and TruNatomy Glider in simulated curved canal.

Objectives: This study aimed to compare the torsional and cyclic fatigue resistance of ProGlider (PG), WaveOne Gold Glider (WGG), and TruNatomy Glider (TNG). Materials and Methods: A total of 15 instruments of each glide path system (n = 15) were used for each test. A custom-made device simulating an angle of 90° and a radius of 5 millimeters was used to assess cyclic fatigue resistance, with calculation of number of cycles to failure. Torsional fatigue resistance was assessed by maximum torque and angle of rotation. Fractured instruments were examined by scanning electron microscopy (SEM). Data were analyzed with Shapiro-Wilk and Kruskal-Wallis tests, and the significance level was set at 5%. Results: The WGG group showed greater cyclic fatigue resistance than the PG and TNG groups (p < 0.05). In the torsional fatigue test, the TNG group showed a higher angle of rotation, followed by the PG and WGG groups (p < 0.05). The TNG group was superior to the PG group in torsional resistance (p < 0.05). SEM analysis revealed ductile morphology, typical of the 2 fracture modes: cyclic fatigue and torsional fatigue. Conclusions: Reciprocating WGG instruments showed greater cyclic fatigue resistance, while TNG instruments were better in torsional fatigue resistance. The significance of these findings lies in the identification of the instruments' clinical applicability to guide the choice of the most appropriate instrument and enable the clinician to provide a more predictable glide path preparation.

Influence of temperature on the torsional properties of two thermally treated NiTi rotary instruments.

This study aimed to evaluate the influence of temperature on torsional strength and angular deflection of two experimental NiTi rotary instruments manufactured from Blue and Gold thermal treatments and with identical cross-sections. A total of 40 experimental NiTi instruments 25.06 and with a triangular cross-section and manufactured from Blue and Gold thermal treatments were used (n=20). The torsional test was performed in the 3 mm from the tip of the instrument according to ISO 3630-1. The torsional test evaluated the torsional strength and angular deflection to failure at room temperature (21°C ± 1° C) and body temperature (36°C ±1°C). The fractured surface of each fragment was observed by using scanning electron microscopy (SEM). Data were analyzed using an unpaired t test for inter and intra-group comparison and the level of significance was set at 5%. The results showed that the body temperature did not affect the torsional strength and angular deflection of the instruments when compared with room temperature (P>0.05). However, at body temperature, the Blue NiTi instruments presented significantly lower angular deflection in comparison with Gold NiTi instruments (P<0.05). There was no significant difference regarding the torsional strength of the instruments at body temperature (P>0.05). The temperature did not affect the torsional strength of the instruments manufactured from Blue and Gold technology. However, the Blue NiTi instruments presented significantly lower angular deflection than Gold instruments at 36°C temperature.

New Ultrasonic Tip for Root Canal Filling of the Mesial Canals of Mandibular Molars with Isthmus: A Laboratory Evaluation Using Computed Microtomography.

INTRODUCTION: The obturation quality of the mandibular molar mesial canals and isthmuses with two thermoplastic techniques, ultrasonic vertical condensation (UVC) and continuous wave of condensation (CWC), was evaluated using computed microtomography (µCT). METHODS: Thirty-six human mandibular molars had been previously scanned and analyzed using µCT for mesial roots with morphologically similar isthmuses for this study. Coronal access and confirmation of foraminal patency were performed, and the actual length of the teeth was established using a clinical microscope (40X magnification). The canals were prepared using ProTaper Gold instruments up to #F3, with 2.5% sodium hypochlorite as the irrigant solution, followed by a passive ultrasonic irrigation protocol. The specimens were randomly divided into the UVC and CWC groups based on the obturation technique to be used. Obturation was performed with #F3 gutta-percha cones cemented using AH Plus Jet sealer. The µCT scans were performed after 15 days, and the images were evaluated by a calibrated examiner blinded to the experimental groups to determine the filling rate of the entire canal area, including the main canal and isthmus. Student's t-test was used for statistical analysis; P values ≤0.05 were considered significant. RESULTS: Neither of the thermoplastic obturation techniques achieved complete filling of the canals (86.3% for UVC and 91.4% for CWC), with a statistically significant difference between them (P = .029). CONCLUSIONS: Under the conditions of the study, it can be concluded that none of the techniques completely filled the canal/isthmus of the mandibular molars; however, the CWC exhibited better performance.